An Oncology Nurse’s Heart: Helping Dying Patients Find Their Own Paths Home

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Heart Break = Heartache graphite, charcoal, water color, adhesive strip by julianna paradisi Heart Break = Heartache
graphite, charcoal, watercolor, adhesive strip, by julianna paradisi

The disadvantage of building a nursing career in oncology is that a fair number of patients die. Despite great advances in treatment, not every patient can be saved. Oncology care providers struggle to balance maintaining hope with telling patients the truth.

Sometimes, telling the truth causes anger, and patients criticize providers for “giving up on me.” In a health care climate that measures a provider’s performance in positive customer satisfaction surveys, paradoxes abound for those working in oncology.

Providers may also be criticized for delivering care that is futile. “Don’t chemo a patient to death” and “A cancer patient should not die in an ICU” are common mantras of merit.

Maybe because I live in Oregon, a state with a Death with Dignity law, or maybe it’s the pioneer spirit of Oregonians, but I don’t meet a lot of patients choosing futile care to prolong the inevitable. In fact, many patients I meet dictate how much treatment they will accept. They grieve when they learn they have incurable cancer, and most choose palliative treatment […]

2016-11-21T13:02:13-05:00July 24th, 2015|career, Nursing, nursing perspective, patient engagement, Patients|3 Comments
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Heatstroke in Older Adults: A Short Step from Heat Exhaustion

Signs and Symptoms of Heat Illness Signs and Symptoms of Heat Illness

Older adults tend to be more vulnerable than younger adults in a number of ways, one of which is in their reaction to intense heat.

Given the increase in extreme weather events in recent years, an article that we published a few years back, “Heatstroke in Older Adults” (free until September 1), is as timely now as ever. A high percentage of heat-related deaths in the U.S. occur among people who are 65 or older. Here are some of the reasons:

Older adults’ normal temperature-regulating processes may be impaired by illnesses such as diabetes or cardiovascular disease or by medications such as vasoconstrictors or diuretics, leaving them more vulnerable to heat exhaustion, which can progress to heatstroke, a far more dangerous condition. Those who are immobilized or suffer from disorientation secondary to dementia may fail to recognize dangerous symptoms or to drink appropriate types and amounts of fluids or move to a cooler location. Isolation, which is also frequently associated with heat injury, is common among older adults, particularly in cities, which are more susceptible to extreme heat waves because they create ‘heat islands,’ where surface and air temperatures are as much as 10°F higher than those in surrounding areas.

This short article gives nurses essential information on:

2016-11-21T13:02:16-05:00July 22nd, 2015|Nursing|0 Comments
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Working a Shift with Theresa Brown

bookBy Maureen Shawn Kennedy, AJN editor-in-chief

Many of you may be familiar with Theresa Brown, nurse and author of Critical Care: A New Nurse Faces Death, Life, and Everything in Between, as well as a blogger for the New York Times. Brown also writes a quarterly column for AJN called What I’m Reading (her latest column, which will be free until August 15, is in the July issue). Her new book, The Shift: One Nurse, Twelve Hours, Four Patients’ Lives, will come out in September, and I was able to read a prepublication copy. (You can pre-order it.)

I don’t usually write book reviews. I think of most books like food: what one person finds delicious may be less savory to another. But I’m making an exception because this book is an accurate and well-written portrayal of nursing (at last!).

Anyone who wants to know what it’s like to be a nurse in a hospital today should read this book. Patients, families, and non-nurse colleagues tend to see nurses as ever-present yet often in the background, quietly moving from room to room, attending to patients, and distributing medications or charting at computers. But what they don’t understand about what nurses do is what Brown so deftly describes—the cognitive multitasking and constant reordering of priorities that occur in the course of one shift as Brown manages the needs of four very different […]

2016-11-21T13:02:17-05:00July 20th, 2015|career, Nursing, nursing perspective|3 Comments
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Hepatitis A, B, and C: The Latest on Screening, Epidemiology, Prevention, Treatments

One of several posters created by the Centers for Disease Control and Prevention to raise awareness that millions of Americans of all ages, races, and ethnicities have hepatitis C—and many don’t know it. Posters are available to order or download for printing at www.cdc.gov/knowmorehepatitis/media/posters.htm. Poster © Centers for Disease Control and Prevention. One of several CDC posters intended to raise awareness that millions of Americans of all ages, races, and ethnicities have hepatitis C—and many don’t know it. Posters are available to order or download for printing at www.cdc.gov/knowmorehepatitis/media/posters.htm. Poster © Centers for Disease Control and Prevention.

It’s crucial that nurses in all health care settings stay informed about the changing landscape of viral hepatitis in the United States. Hepatitis affects the lives of millions, too many of whom are unaware that they have been infected.

Right now, there’s good news and bad news about hepatitis in the U.S. While the incidences of hepatitis A and B in the United States have declined significantly in the past 15 years, the incidence of hepatitis C virus infection, […]

2016-11-21T13:02:17-05:00July 16th, 2015|Nursing|1 Comment
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More than ‘Just’ Fragile Skin and Loose Joints: A Nurse’s Guide to Ehlers-Danlos Syndrome

By Sylvia Foley, AJN senior editor

“Most of the local doctors … thought I was making this up.”—patient on online forum

Joint hypermobility is often characteristic of EDS. Photo © 2015 Suzbah / Dreamstime.com. Joint hypermobility is often characteristic of EDS. Photo © 2015 Suzbah / Dreamstime.com.

You might not have heard of Ehlers–Danlos syndrome (EDS), but chances are you’ve had a patient with this hereditary connective tissue disorder, which affects an estimated one in 5,000 people worldwide. The real number is probably higher. There are six types of EDS with widely varying presentations—and given the lack of consensus regarding diagnostic criteria, underrecognition seems likely.

Primary symptoms can include skin hyperelasticity, joint hypermobility, and general tissue fragility; the effects can be disabling and even life threatening. In one of this month’s CE features, “Nursing Management of Patients with Ehlers–Danlos Syndrome,” author Linda K. Anderson offers nurses a clear guide to this condition. Here’s a short summary: […]

2017-07-27T14:40:17-04:00July 14th, 2015|Nursing|5 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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